141 research outputs found

    IMPACTO DEL CREDITO FORMAL EN MICROEMPRESAS TEXTILES ATENDIDAS POR MIBANCO. AREQUIPA – 2011.

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    La presente investigación tiene como objetivo determinar el impacto del microcrédito en el nivel de bienestar de microempresas textiles que son atendidas por MIBANCO en la ciudad de Arequipa. Se utilizó la base de datos de la sede de MIBANCO en la ciudad de Arequipa. De la información proporcionada por el Departamento de Información Estadística de MIBANCO se identificó la población: 126 microempresas textiles cuyo último crédito fue otorgado entre los meses de enero y octubre de 2011, que vienen operando en el mercado no menos de 5 años y que sus ingresos provienen únicamente de su actividad microempresarial, de acuerdo al reporte realizado por los analistas de créditos en el proceso de evaluación de créditos. El estudio concluye que: 1) El microcrédito está generando un impacto positivo y significativo en el nivel de bienestar económico de las microempresas textiles, ya que el 60% de microempresas ha incrementado sus ventas en el orden del 50% y el 66,32% ha incrementado sus ingresos netos mensuales en el orden del 50%. Esto no ocurre con las microempresas que no han recibido microcrédito. 2) El microcrédito está generando un impacto positivo en el nivel de bienestar administrativo de las microempresas textiles, ya que el 54,74% de microempresas que han recibido microcrédito vienen operando de 11 a 15 años, el 50,53% de microempresas tiene de 7 a 10 empleados nombrados y el 80% de microempresas textiles tiene una fuerte credibilidad ante sus clientes. Esto no ocurre con las microempresas que no han recibido microcrédito. 3) El microcrédito está reduciendo la vulnerabilidad del 90,53% de microempresas textiles, ya que tienen una solidez financiera y pueden recibir mása créditos. Esto no ocurre con las microempresas que no han recibido microcrédito. 4) El nivel de bienestar (a nivel económico, administrativo y de vulnerabilidad) de las microempresas textiles que han recibido microcrédito son mayores en comparación al nivel de bienestar de las microempresas textiles que no lo han recibido

    The impact of routine outcome measurement on treatment processes in community mental health care: approach and methods of the MECCA study

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    Three issues characterise the background to the MECCA study: A) Throughout Europe, most patients with severe forms of psychotic disorders are cared for in the community. The challenge now is to make processes in community mental health care more effective. B) There are widespread calls to implement regular outcome measurement in routine settings. This, however, is more likely to happen, if it provides a direct benefit to clinicians and patients. C) Whilst user involvement is relatively ?" easy to achieve on a political level, new mechanisms may have to be established to make the views of patients feed into individual treatment decisions. The MECCA study is a cluster randomised controlled trial following the same protocol in community mental health teams in six European countries. In the experimental group, patients' subjective quality of life, treatment satisfaction and wishes for different or additional help are assessed in key worker-patient meetings every two months and intended to inform the therapeutic dialogue and treatment decisions. The trial tests the hypothesis that the intervention - as compared to current best standard practice - will lead to a better outcome in terms of quality of life and other criteria in patients with psychotic disorders over a one year period. This more favourable outcome is assumed to be mediated through different treatment input based on more appropriate joint decisions or a more positive therapeutic relationship in line with a partnership model of care or both. Moreover, the study will hopefully reveal new insights into how therapeutic processes in community mental health care work and how they can be optimise

    Factores de riesgo de reluxación de cadera en pacientes post-quirúrgicos de luxación congénita de cadera, en un hospital del seguro social

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    Introducción: La reluxación postquirúrgica, es la segunda complicación más frecuente luego de una reducción abierta correctiva de luxación congénita de cadera, por qué y cómo se producen aún no han sido resueltos. Objetivo: identificar los factores de riesgo de este evento en el servicio de C.O.T. del H.B.A.A.A. Material y métodos: se realizó un estudio Observacional, Analítico, Transversal y Retrospectivo; con diseño Casos y Controles. La población fue todo paciente que fuera intervenido por el diagnostico de Luxación congénita de cadera codificado por los CIE-10: Q65,0, Q65,1 o Q65,2 en el servicio de C.O.T. del H.B.A.A.A. en el periodo 2010 – 2015, se realizó muestreo por Epidat 3.1, ordenando 2 controles por cada caso: 28 casos y 56 controles. La definición de caso fue todo paciente perteneciente a la población descrita y que presenta reluxación de la cadera intervenida. Se realizó descripción de frecuencias, pruebas de contrastación de hipótesis y finalmente modelos lineales generalizados para calcular el Odds-ratio como medida de asociación, con el paquete estadístico STATA 13. Resultados: Se logró contar con 26 casos y 51 controles, la osteotomía femoral Desrotatoria presenta OR 2,88; p<0,05 IC:95%; las osteotomía femorales Desrotatoria y Varizante en una misma cirugía presentan OR 1,75; p>0,05 IC:95% y la osteotomía pélvica tipo Klissic presenta OR 1.5; p>0,05 IC: 95% Conclusión: nuestra investigación identifica en orden descendente como factores de riesgo: el uso osteotomía femoral Desrotatoria y Varizante, osteotomía pélvica tipo Dega , técnica de Klissic y procedimiento de retiro total del labrum

    Reproductive Biology of Common Small Pelagic Fishes in Manila Bay, Philippines

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    Reproductive biology of the three dominant species (Sardinella gibbosa, Sardinella fimbriata, and Rastrelliger kanagurta) were studied in Manila Bay from January 2014 to December 2015. The data were collected from landed catch (coming from gillnet, lift net, purse seine, ringnet, and trawl) and during the actual trawl fishing survey. A total of 2,383 Sardinella gibbosa, 2,334 Sardinella fimbriata, and 549 Rastrelliger kanagurta were analyzed by pooling the two years data. The overall female to male ratio conformed to the expected 1:1 sex ratio. These species spawn throughout the year with major peak in March and April and minor peak in October to December for Sardinella gibbosa; with major peak in February to May and minor peak in October to December for Sardinella fimbriata; and for Rastrelliger kanagurta, with major peak in October to December and minor peak in May and June. The GSI values correlate with the maturation of the gonads of these species. The length at maturity (Lm50) was calculated at 12.75 cm in males and 13.25 cm in females for S. gibbosa; 12.25 cm in males and 12.75 cm in females for S. fimbriata; and 25.5 cm in males and 24.5 cm in females for R. kanagurta

    Epigenetic mechanisms and posttranslational Modifications in systemic lupus erythematosus

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    The complex physiology of eukaryotic cells is regulated through numerous mechanisms, including epigenetic changes and posttranslational modifications. The wide-ranging diversity of these mechanisms constitutes a way of dynamic regulation of the functionality of proteins, their activity, and their subcellular localization as well as modulation of the di erential expression of genes in response to external and internal stimuli that allow an organism to respond or adapt to accordingly. However, alterations in these mechanisms have been evidenced in several autoimmune diseases, including systemic lupus erythematosus (SLE). The present review aims to provide an approach to the current knowledge of the implications of these mechanisms in SLE pathophysiology

    Study protocol of a randomized controlled trial to assess safety of teleconsultation compared with face-to-face consultation: the ECASeT study

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    BackgroundThe use of remote consultation modalities has exponentially grown in the past few years, particularly since the onset of the COVID-19 pandemic. Although a huge body of the literature has described the use of phone (tele) and video consultations, very few of the studies correspond to randomized controlled trials, and none of them has assessed the safety of these consultation modalities as the primary objective. The primary objective of this trial was to assess the safety of remote consultations (both video and teleconsultation) in the follow-up of patients in the hospital setting.MethodsMulticenter, randomized controlled trial being conducted in four centers of an administrative healthcare area in Catalonia (North-East Spain). Participants will be screened from all individuals, irrespective of age and sex, who require follow-up in outpatient consultations of any of the departments involved in the study. Eligibility criteria have been established based on the local guidelines for screening patients for remote consultation. Participants will be randomly allocated into one of the two study arms: conventional face-to-face consultation (control) and remote consultation, either teleconsultation or video consultation (intervention). Routine follow-up visits will be scheduled at a frequency determined by the physician based on the diagnostic and therapy of the baseline disease (the one triggering enrollment). The primary outcome will be the number of adverse reactions and complications related to the baseline disease. Secondary outcomes will include non-scheduled visits and hospitalizations, as well as usability features of remote consultations. All data will either be recorded in an electronic clinical report form or retrieved from local electronic health records. Based on the complications and adverse reaction rates reported in the literature, we established a target sample size of 1068 participants per arm. Recruitment started in May 2022 and is expected to end in May 2024.DiscussionThe scarcity of precedents on the assessment of remote consultation modalities using randomized controlled designs challenges making design decisions, including recruitment, selection criteria, and outcome definition, which are discussed in the manuscript.Trial registrationNCT05094180. The items of the WHO checklist for trial registration are available in Additional file 1. Registered on 24 November 2021

    Two super-Earths at the edge of the habitable zone of the nearby M dwarf TOI-2095

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    The main scientific goal of TESS is to find planets smaller than Neptune around stars bright enough to allow further characterization studies. Given our current instrumentation and detection biases, M dwarfs are prime targets to search for small planets that are in (or nearby) the habitable zone of their host star. Here we use photometric observations and CARMENES radial velocity measurements to validate a pair of transiting planet candidates found by TESS. The data was fitted simultaneously using a Bayesian MCMC procedure taking into account the stellar variability present in the photometric and spectroscopic time series. We confirm the planetary origin of the two transiting candidates orbiting around TOI-2095 (TIC 235678745). The star is a nearby M dwarf (d=41.90±0.03d = 41.90 \pm 0.03 pc, Teff=3759±87T_{\rm eff} = 3759 \pm 87 K, V=12.6V = 12.6 mag) with a stellar mass and radius of M=0.44±0.02  MM_\star = 0.44 \pm 0.02 \; M_\odot and R=0.44±0.02  RR_\star = 0.44 \pm 0.02 \; R_\odot, respectively. The planetary system is composed of two transiting planets: TOI-2095b with an orbital period of Pb=17.66484±(7×105)P_b = 17.66484 \pm (7\times 10^{-5}) days and TOI-2095c with Pc=28.17232±(14×105)P_c = 28.17232 \pm (14\times 10^{-5}) days. Both planets have similar sizes with Rb=1.25±0.07  RR_b = 1.25 \pm 0.07 \; R_\oplus and Rc=1.33±0.08  RR_c = 1.33 \pm 0.08 \; R_\oplus for planet b and c, respectively. We put upper limits on the masses of these objects with Mb<4.1  MM_b < 4.1 \; M_\oplus for the inner and Mc<7.4  MM_c < 7.4 \; M_\oplus for the outer planet (95\% confidence level). These two planets present equilibrium temperatures in the range of 300 - 350 K and are close to the inner edge of the habitable zone of their star.Comment: Submitted to Astronomy & Astrophysic

    Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

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    BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

    Local hydrological conditions influence tree diversity and composition across the Amazon basin

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    Tree diversity and composition in Amazonia are known to be strongly determined by the water supplied by precipitation. Nevertheless, within the same climatic regime, water availability is modulated by local topography and soil characteristics (hereafter referred to as local hydrological conditions), varying from saturated and poorly drained to well-drained and potentially dry areas. While these conditions may be expected to influence species distribution, the impacts of local hydrological conditions on tree diversity and composition remain poorly understood at the whole Amazon basin scale. Using a dataset of 443 1-ha non-flooded forest plots distributed across the basin, we investigate how local hydrological conditions influence 1) tree alpha diversity, 2) the community-weighted wood density mean (CWM-wd) – a proxy for hydraulic resistance and 3) tree species composition. We find that the effect of local hydrological conditions on tree diversity depends on climate, being more evident in wetter forests, where diversity increases towards locations with well-drained soils. CWM-wd increased towards better drained soils in Southern and Western Amazonia. Tree species composition changed along local soil hydrological gradients in Central-Eastern, Western and Southern Amazonia, and those changes were correlated with changes in the mean wood density of plots. Our results suggest that local hydrological gradients filter species, influencing the diversity and composition of Amazonian forests. Overall, this study shows that the effect of local hydrological conditions is pervasive, extending over wide Amazonian regions, and reinforces the importance of accounting for local topography and hydrology to better understand the likely response and resilience of forests to increased frequency of extreme climate events and rising temperatures
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